BREAST BIOPSY LESION CONCORDANCE/DISCORDANCE: CHALLENGES IN MEETING REPORTING STANDARDS IN THE THIRD WORLD.

Abstract

Introduction: Percutaneous ultrasound guided breast biopsy has become the standard for diagnosis benign and malignant breast lesions. This modality closely shares its false negative rates with open surgical biopsy^1,2. However, the possibility of discordance between breast imaging and final pathological diagnosis can occur.³Our aim is to detect the compliance rate of imaging-pathology concordance/discordance documentation in our tertiary care unit and to evaluate the concordance and discordance between imaging and histopathology of ultrasound-guided breast biopsy.

Method: We included patients who underwent breast biopsies performed at the tertiary unit. The first audit cycle was conducted retrospectively, between 1st April 2019 to 19th June 2019. Compliance was measured as added addendums to biopsy reports, confirming the histopathological result and correlation with imaging. A manual alerting system for flagging up the availability of pathology reports was implemented. The second cycle was performed from 1st October 2019 to 31st December 2019.

Results: Out of the total 58 biopsies performed in the first cycle, 26 (44%) had report addendums added for pathology-histology concordance/discordance. Postintervention, this compliance increased, with 96 of the 115 biopsies having added addendums (80.8%). Regarding histopathology results 25% breast biopsy results were dis-concordant, most of which are dis-concordant benign.

Conclusion:  The compliance increased significantly by creating awareness -and alert system for adding addendum to breast biopsy reports after the first audit results. Regarding concordance and discordance imaging and histopathology results out of 81 BI-RADS IV cases, 30 cases were further categorized which is only 37%. Which require further improvement.

 Key words: Addendums, breast biopsy, concordance/discordance